1
HESI RN Exit Exam V1–V7 2025/2026 | 250 Verified
Questions Per Version | NCLEX-Style Answers & Rationales
| A+ Rated Test Bank
1. A nurse is caring for a 36-year-old client who has just undergone a laparoscopic
cholecystectomy. The client is now 4 hours postoperative and reports shoulder pain
rated 6/10. Vital signs are stable, and the surgical site is dry and intact. Which
intervention should the nurse prioritize to relieve the client’s shoulder pain?
A. Administer IV morphine as prescribed
B. Apply heat to the shoulder
C. Encourage ambulation and position changes
D. Contact the surgeon for abnormal pain
Correct Answer: C. Encourage ambulation and position changes
Rationale: After laparoscopic procedures, residual carbon dioxide used for
insufflation can cause referred shoulder pain due to diaphragmatic irritation.
Encouraging ambulation and repositioning facilitates absorption of the gas and
helps alleviate discomfort. While pain medication can be given, it is more
appropriate to address the underlying cause first. Heating pads are not
recommended without provider order. Contacting the surgeon is premature without
, 2
trying standard interventions. (Reference: HESI Comprehensive Review, 6th
Ed.)
2. A client with newly diagnosed Type 1 Diabetes Mellitus is being discharged.
Which statement made by the client indicates an understanding of insulin therapy?
A. “I will stop taking insulin if I feel dizzy or shaky.”
B. “I can skip insulin doses when I eat less.”
C. “I will rotate injection sites in the same anatomical area.”
D. “I will inject insulin directly into my thigh muscle.”
Correct Answer: C. “I will rotate injection sites in the same anatomical area.”
Rationale: Rotating injection sites within the same anatomical region (e.g.,
abdomen) helps prevent lipodystrophy and ensures consistent absorption rates.
Clients should not skip insulin doses based on food intake without provider
guidance. Injecting insulin intramuscularly alters absorption. Feeling shaky may
indicate hypoglycemia, which requires carbohydrate intake, not insulin cessation.
(Source: HESI Comprehensive Review, 6th Ed.)
3. A nurse is providing discharge teaching to a client prescribed warfarin for atrial
fibrillation. Which instruction is most important for the nurse to include?
A. “Eat more leafy greens to stay healthy.”
B. “Avoid using electric razors.”
C. “Report any signs of bleeding or bruising.”
D. “Double your dose if you miss one.”
Correct Answer: C. “Report any signs of bleeding or bruising.”
Rationale: Warfarin increases the risk of bleeding. Clients must be educated on
the importance of recognizing bleeding signs such as bruising, nosebleeds, or dark
stools. Green leafy vegetables (high in vitamin K) should be kept consistent in the
, 3
diet—not increased. Electric razors are actually safer than blades. Doubling doses
is dangerous and contraindicated. (Source: HESI Pharmacology Review 2025)
4. A nurse assesses a client receiving a blood transfusion who begins to experience
chills, fever (101.2°F), and back pain. What is the nurse’s priority action?
A. Administer acetaminophen
B. Slow the infusion rate
C. Stop the transfusion immediately
D. Notify the blood bank after transfusion ends
Correct Answer: C. Stop the transfusion immediately
Rationale: The client is experiencing signs of an acute hemolytic reaction, a life-
threatening transfusion reaction. The nurse must immediately stop the transfusion,
maintain IV access with normal saline, and notify the provider and blood bank.
Administering acetaminophen or slowing the infusion is inappropriate and delays
treatment. (Source: Saunders 10th Ed., Transfusion Nursing)
5. A nurse is caring for a client with a serum sodium level of 128 mEq/L. The
client is alert and oriented but reports headache and nausea. What is the most
appropriate nursing intervention?
A. Restrict oral fluid intake
B. Encourage high-sodium foods
C. Administer loop diuretics
D. Provide hypotonic IV fluids
Correct Answer: A. Restrict oral fluid intake
, 4
Rationale: A serum sodium of 128 mEq/L indicates hyponatremia, often caused
by fluid overload. Fluid restriction is a primary intervention to prevent further
sodium dilution. Diuretics may worsen sodium loss, and hypotonic fluids are
contraindicated. High-sodium foods may help but are not as effective as fluid
restriction. (Source: HESI Med-Surg Review)
6. A nurse receives a handoff report about a client with heart failure who gained
2.5 kg in 2 days and reports shortness of breath while lying down. Which nursing
action is most appropriate?
A. Reassure the client and monitor
B. Encourage fluid intake
C. Place the client in high-Fowler’s position and notify provider
D. Provide a low-sodium meal tray
Correct Answer: C. Place the client in high-Fowler’s position and notify
provider
Rationale: Rapid weight gain, orthopnea, and fluid retention are signs of acute
decompensated heart failure. High-Fowler’s position improves breathing. The
provider should be notified promptly. Reassurance or fluids could worsen
symptoms. A low-sodium diet is helpful long term but not the priority now.
(Reference: Brunner & Suddarth’s Medical-Surgical Nursing, 15th Ed.)
7. A nurse is teaching a pregnant client with preeclampsia about warning signs.
Which client statement indicates a need for further teaching?
HESI RN Exit Exam V1–V7 2025/2026 | 250 Verified
Questions Per Version | NCLEX-Style Answers & Rationales
| A+ Rated Test Bank
1. A nurse is caring for a 36-year-old client who has just undergone a laparoscopic
cholecystectomy. The client is now 4 hours postoperative and reports shoulder pain
rated 6/10. Vital signs are stable, and the surgical site is dry and intact. Which
intervention should the nurse prioritize to relieve the client’s shoulder pain?
A. Administer IV morphine as prescribed
B. Apply heat to the shoulder
C. Encourage ambulation and position changes
D. Contact the surgeon for abnormal pain
Correct Answer: C. Encourage ambulation and position changes
Rationale: After laparoscopic procedures, residual carbon dioxide used for
insufflation can cause referred shoulder pain due to diaphragmatic irritation.
Encouraging ambulation and repositioning facilitates absorption of the gas and
helps alleviate discomfort. While pain medication can be given, it is more
appropriate to address the underlying cause first. Heating pads are not
recommended without provider order. Contacting the surgeon is premature without
, 2
trying standard interventions. (Reference: HESI Comprehensive Review, 6th
Ed.)
2. A client with newly diagnosed Type 1 Diabetes Mellitus is being discharged.
Which statement made by the client indicates an understanding of insulin therapy?
A. “I will stop taking insulin if I feel dizzy or shaky.”
B. “I can skip insulin doses when I eat less.”
C. “I will rotate injection sites in the same anatomical area.”
D. “I will inject insulin directly into my thigh muscle.”
Correct Answer: C. “I will rotate injection sites in the same anatomical area.”
Rationale: Rotating injection sites within the same anatomical region (e.g.,
abdomen) helps prevent lipodystrophy and ensures consistent absorption rates.
Clients should not skip insulin doses based on food intake without provider
guidance. Injecting insulin intramuscularly alters absorption. Feeling shaky may
indicate hypoglycemia, which requires carbohydrate intake, not insulin cessation.
(Source: HESI Comprehensive Review, 6th Ed.)
3. A nurse is providing discharge teaching to a client prescribed warfarin for atrial
fibrillation. Which instruction is most important for the nurse to include?
A. “Eat more leafy greens to stay healthy.”
B. “Avoid using electric razors.”
C. “Report any signs of bleeding or bruising.”
D. “Double your dose if you miss one.”
Correct Answer: C. “Report any signs of bleeding or bruising.”
Rationale: Warfarin increases the risk of bleeding. Clients must be educated on
the importance of recognizing bleeding signs such as bruising, nosebleeds, or dark
stools. Green leafy vegetables (high in vitamin K) should be kept consistent in the
, 3
diet—not increased. Electric razors are actually safer than blades. Doubling doses
is dangerous and contraindicated. (Source: HESI Pharmacology Review 2025)
4. A nurse assesses a client receiving a blood transfusion who begins to experience
chills, fever (101.2°F), and back pain. What is the nurse’s priority action?
A. Administer acetaminophen
B. Slow the infusion rate
C. Stop the transfusion immediately
D. Notify the blood bank after transfusion ends
Correct Answer: C. Stop the transfusion immediately
Rationale: The client is experiencing signs of an acute hemolytic reaction, a life-
threatening transfusion reaction. The nurse must immediately stop the transfusion,
maintain IV access with normal saline, and notify the provider and blood bank.
Administering acetaminophen or slowing the infusion is inappropriate and delays
treatment. (Source: Saunders 10th Ed., Transfusion Nursing)
5. A nurse is caring for a client with a serum sodium level of 128 mEq/L. The
client is alert and oriented but reports headache and nausea. What is the most
appropriate nursing intervention?
A. Restrict oral fluid intake
B. Encourage high-sodium foods
C. Administer loop diuretics
D. Provide hypotonic IV fluids
Correct Answer: A. Restrict oral fluid intake
, 4
Rationale: A serum sodium of 128 mEq/L indicates hyponatremia, often caused
by fluid overload. Fluid restriction is a primary intervention to prevent further
sodium dilution. Diuretics may worsen sodium loss, and hypotonic fluids are
contraindicated. High-sodium foods may help but are not as effective as fluid
restriction. (Source: HESI Med-Surg Review)
6. A nurse receives a handoff report about a client with heart failure who gained
2.5 kg in 2 days and reports shortness of breath while lying down. Which nursing
action is most appropriate?
A. Reassure the client and monitor
B. Encourage fluid intake
C. Place the client in high-Fowler’s position and notify provider
D. Provide a low-sodium meal tray
Correct Answer: C. Place the client in high-Fowler’s position and notify
provider
Rationale: Rapid weight gain, orthopnea, and fluid retention are signs of acute
decompensated heart failure. High-Fowler’s position improves breathing. The
provider should be notified promptly. Reassurance or fluids could worsen
symptoms. A low-sodium diet is helpful long term but not the priority now.
(Reference: Brunner & Suddarth’s Medical-Surgical Nursing, 15th Ed.)
7. A nurse is teaching a pregnant client with preeclampsia about warning signs.
Which client statement indicates a need for further teaching?
